A significant gap persists between research findings and their application in policy and practice. Implementation science addresses this "know-do" gap by focusing on context, systems, and stakeholders to facilitate evidence uptake. Knowledge translation (KT) is a key implementation science approach, defined as the synthesis, dissemination, exchange, and application of knowledge to improve health outcomes. Academic institutions are ideally positioned for KT, yet their success varies. Previous research, primarily from high-income countries (HICs), has identified barriers such as lack of KT knowledge, challenges in planning and implementation, weak stakeholder relationships, and ineffective communication. A review by Jones et al. (2015) highlighted the need for researchers to understand KT theory, plan and implement KT efforts, develop relationships with end-users, and communicate effectively. However, these findings largely stem from HIC research, with limited understanding of the context in low- and middle-income countries (LMICs). Assessing institutional readiness for KT, encompassing motivation and capacity at individual and institutional levels, offers a valuable approach. Weiner (2009) emphasizes that organizational readiness is a multi-faceted construct influenced by internal and external contexts, culture, resources, perceptions, and shared values for change. While readiness assessments exist, they primarily focus on capacity in HICs and lack attention to motivation. This study aims to describe KT needs and barriers within LMIC academic institutions, identifying factors relevant for assessing institutional readiness and informing capacity-building strategies.

The paper reviewed existing literature on knowledge translation, organizational readiness, and barriers and facilitators to KT, primarily focusing on studies conducted in high-income countries. This review highlighted previously identified challenges such as lack of knowledge about KT processes, limited institutional resources (funding, time, staff), insufficient support for KT activities, and the crucial need for leadership engagement. The authors also examined implementation science frameworks like the Promoting Action on Research in Health Services (PARiHS) framework and the Consolidated Framework for Implementation Research (CFIR) to identify relevant constructs for assessing institutional readiness. They found that these frameworks are under-developed for LMIC contexts and that there's a lack of empirical studies exploring the most relevant constructs in these settings. This literature review served to inform the study's methodology and to provide a benchmark against which to compare the findings from the qualitative data collection in LMICs.

This qualitative study used a mixed-methods approach, incorporating document reviews and key informant interviews (KIIs). Document review involved analyzing institutional information (organograms, websites, strategic plans) from six academic institutions participating in the Synthesis and Translation of Research and Innovations in Polio Eradication (STRIPE) project, and public information from respective Ministries of Health (MOHs). Content analysis focused on identifying research priorities, future directions, national health priorities, and key decision-makers. The literature review used PubMed and Google Scholar to identify barriers, facilitators, and strategies for KT and readiness assessment. The KIIs aimed to understand institutional readiness for KT, exploring experiences, barriers, facilitators, motivation, and capacity-building strategies. Participants included representatives from the six STRIPE academic institutions and their MOH partners. Participants were selected based on involvement in KT activities, strategic decision-making, or leadership roles. Eighteen KIIs were conducted (11 with academic institution members and 7 with policymakers) in English, using in-person or remote methods. Data analysis employed a deductive approach using Potter and Brough's capacity building pyramid and the CFIR, complemented by inductive coding to capture emerging themes. Dedoose software facilitated the analysis. The study aimed to inform the development of a quantitative tool to assess institutional readiness for KT.

The study confirmed several well-documented barriers to KT, including lack of KT knowledge and skills, limited institutional resources, insufficient support, and need for leadership engagement. Three key emergent themes emerged from the data: 1. **Complexity of Policy Processes and Soft Skills:** The policymaking process was described as complex, with junior researchers often lacking the soft skills (e.g., emotional intelligence, communication) to effectively engage with policymakers. 2. **Misalignment of Institutional Missions and Incentives:** While KT was often included in institutional missions, it frequently lacked clear metrics for success, leading to misalignment between institutional priorities and individual incentives for researchers (e.g., promotion based on publications, not KT). 3. **Role of Networks:** Strong internal and external networks were crucial, but challenging to establish and maintain due to time constraints, competing priorities, and limited institutional support. The study also highlighted the importance of relationships with policymakers, with trust and ongoing engagement being key to success, even while acknowledging difficulties related to staff turnover and institutional changes. Participants consistently emphasized the lack of time as a major barrier for both researchers and policymakers, while suggesting that institutional support and dedicated staffing are essential for sustainable KT activities. Soft skills, particularly those required for effective communication and collaboration with policymakers, were identified as lacking in researchers and highlighted as important aspects for future training.

This research corroborates previous findings on barriers to KT while adding critical insights into the institutional context within LMICs. The three emergent themes—complexity of policy processes, misalignment of incentives, and the role of networks—underscore the need for multifaceted interventions. The interdependency of these factors necessitates a holistic approach to capacity building. Addressing institutional missions and culture, through strategies such as transformational leadership and multidisciplinary teams, could positively impact multiple barriers simultaneously. The study highlights the need for readiness assessments that incorporate both capacity and motivation, given the scarcity of comprehensive tools tailored to LMICs. The findings further refine our understanding of how to develop institutional-level interventions for KT in LMICs by highlighting the inter-dependency of factors like institutional support, networks, and incentives.

This study emphasizes the critical need for both motivation and capacity to achieve effective KT in LMIC academic institutions. The identified barriers, particularly the interplay between institutional priorities, researcher incentives, and network development, highlight the need for a comprehensive and context-specific approach to capacity building. Future research should focus on developing and testing tailored interventions that address the identified institutional drivers and facilitate sustainable KT practices.

The study's limitations include the limited number of MOH participants in each country, providing a potentially skewed external perspective. The six participating countries may not fully represent the diverse experiences within LMICs. The single researcher conducting and analyzing the interviews raises concerns about reflexivity, although efforts were made to mitigate this through the study's design and the researcher's acknowledgement of potential biases.